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Individual

JACQUELINE K NOLZ LEINGANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
222 N 7TH ST, BISMARCK, ND 58501-4436
(701) 323-6000
(701) 323-5709
Mailing address
222 N 7TH ST, BISMARCK, ND 58501-4436
(701) 323-6000
(701) 323-5709

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
R25543
ND
364S00000X
Clinical Nurse Specialist
Primary
PAC0245
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00235006
MEDICARE RAILROAD
ND
Enumeration date
05/28/2006
Last updated
09/08/2014
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